Blood components Plasma.ppt

M. Zaharna Blood Bank Lab. 2009
1
Blood Components
and Plasma derivatives

2
• The anticoagulants and preservatives that are
added to blood nowadays enable storage for
long periods of time
– Before acid-citrate-dextrose (ACD) was used- 21 days
• Aseptic separation of blood into cellular &
plasma components by the introduction of plastic
collection systems
– Before glass bottles were used

3
Blood collection
• Blood is collected in plastic bag systems
with anticoagulant & preservative
• Whole blood can be stored at 4oC for up to
5 weeks
• Whole blood contains many components
• Wasteful to give whole blood if only red
cells are needed

4
Blood Components
• Human blood consists of
plasma, in which cells are
suspended
• The plasma also contains
other specialised substances,
which are important for blood
clot formation (e.g. clotting
factors)
• Whole blood can be separated
at the blood bank into various
components

5
BLOOD COMPONENTS
• Blood separated into different parts:
1. Packed red cells
2. Platelets
3. Fresh frozen plasma
4. Cryoprecipitate
5. Granulocytes
6. Factor IX conc.
7. Factor VIII conc.
• There are more than 20 different products
available

6
Whole blood
Red cells Plasma Platelets
(Fresh) frozen
plasma (FFP)
Cryoprecipitate
Stored
Plasma
F lX
Immuno-
globulins
Albumin
Fractionated
products
F Vlla
F Vlll
Granulocytes

7
Whole Blood
• One unit contains
• 450 ml of blood
• & 63 ml of anticoagulant-preservative

8
RBC Anticoagulant/Preservative Solutions
• Purpose of RBC Preservation
– Designed to prevent clotting and maintain red cell
viability and function during storage.
– Usual anticoagulant-preservative is CPD-A (Citrate
Phosphate Dextrose Adenine )
• Anticoagulant-Preservative Contents
• Citrate: anticoagulant (binds plasma calcium and prevent
activation of coagulation cascade)
• Phosphate: provide substrate to help maintain red cell 2,3
DPG levels
• Dextrose: a sugar, provides substrate for ATP production.
• Adenine: Acts as a substrate for RBC synthesis of ATP

9
• During storage at 4oC
• Platelets and WBCs
• become nonfunctional during hours of collection
• Red cells
• 5 weeks in CPD-A have a mean recovery 70%
• Plasma
•  K+,  H+ →  pH
• Levels of coagulation factors V & VIII decrease

10
Blood Components
• Refers to a product separated from a
single unit of whole blood
• The term plasma derivative indicates a
blood product separated from a large
volume of pooled plasma by a process
called fractionation

11
• Blood components
– Oxygen carrying components
– Red cell concentrates
(RCC)
– Leukocyte poor blood
– Frozen-thawed red cells
– Platelet products
– Platelet rich plasma (PRP)
– Platelet concentrates (PC)
– Plasma products
– Fresh frozen plasma (FFP)
– Frozen plasma (FP)
– Cryoprecipitate
– Stored plasma
• Plasma Derivatives
– Coagulation Factor concentrates
• Factor VIII concentrates
• Factor IX complex concentrates &
others
– Oncotic agents
• Albumin
• Plasma protein fraction (PPF)
– Immune serum Globulin
• Hepatitis B Ig (HBIG)
• Varicella-zoster Ig (VZIG)
• Rh Ig (RhIG)
• Tetanus Ig (TIG)

12
A- Blood components that carry oxygen
• Increase the oxygen carrying capacity of
the blood by increasing the circulating red
blood cell mass.
• Carry oxygen and nourishment to the
tissues and take away carbon dioxide.

13
C- Plasma Products
• Plt poor plasma can be separated into a
number of products
– Fresh frozen plasma
– Frozen plasma
– Cryoprecipitate
– Stored plasma

14
1- Fresh frozen plasma (FFP)
• Prepared from whole blood
within 6 hours of collection
• Rapid freezing of plasma
preserves the labile
coagulation factors at
maximum levels
• Donot contain cellular
elements
• 200 ml volume
• Stored at -30oC for 12 months

15
2- Frozen Plasma (FP)
• Separated from whole blood within 24
hours of collection
• Contains at least 50 % of original factor
VIII & factor V frozen plasma
• Adequate source for treatment of mild to
moderate coagulation factor deficiencies
• 200 ml volume
• Storage at -30oC for up to 12 months

16
3- Cryoprecipitate
• Produced from freshly separated plasma by
freezing at -70oC followed by thawing at 4oC
• Flocculent precipitate is rich in factor VIII,
fibrinogen and fibronectin
• Once thawed, mixture is centrifuged to sediment
the cryoprecipitate & all but 5 to 10 ml of
supernatant plasma is removed
• Contains 250 mg fibrinogen
• 80 clotting units of factor VIII
• Stored at -30oC for 12 months

17
3- Cryoprecipitate
• Increase of 2% of factor VIII level for each
bag of cryoprecipitate infused
• Supernatant plasma removed is called
stored plasma
– Must be used within 5 weeks if stored at 4oC
– Lasts for 2 years at -30oC

18
4- Stored plasma
• Plasma separated from whole blood after 24 hours of
storage at 4oC
• Can also be derived from cryoprecipitate production
• Contain reduced levels of labile coagulation factors V
VIII & fibrinogen
• It is indicated for patients requiring volume expansion or
protein replacement when labile clotting factors are not
required
• Plasma products do not require crossmatch prior to use
but should be ABO compatible

19
Plasma Derivatives

20
• Certain plasma derivatives can be
obtained by fractionating the fresh frozen
plasma or stored plasma
• Fractionation:
 Allows the processing of large volumes of
pooled plasma
 Pooling of many units increases the risk of
viral transmission to the recipient

21
Plasma protein fractionation
• Plasma proteins are separated according
to differences of each protein.
• Fractionation involves changing the
conditions of the pooled plasma (e.g. the
temperature or the acidity)
• Proteins that are normally dissolved in the
plasma fluid become insoluble, forming
large clumps, called precipitate.
• The insoluble protein can be collected by
centrifugation.

22
• One of the very effective ways for carrying out
this process is the addition of alcohol to the
plasma pool while simultaneously cooling the
pool.
• This process is sometimes called cold alcohol
fractionation or ethanol fractionation.
• This procedure is carried out in a series of steps
so that a single pool of plasma yields several
different protein products, such as albumin and
immune globulin.

23
Plasma Derivatives
Plasma Derivatives Preparation avaliable
Coagulation Factors
Factor VIII concentrates
Factor IX concentrates
Anti-thrombin III
Albumin
Albumin
Plasma protein fraction
Immune globulins
Non-specific immune serum globulin (ISG)
Rh immune globulin (RhIG)
Hepatitis B immune globulin (HBIG)
Varicella-Zoster immune globulin (VZIG)
Tetanus immune globulin (TIG)

24
1- Coagulation Factor Concentrates
• Prepared in a freeze-dried form
• Indicated for patients with congenital
coagulation deficiencies
– Risk of hepatitis is high
• Should not used for mild acquired
coagulation deficiencies
– Should be treated with FP or FFP

25
Factor VIII Concentrate
• Commercially prepared, lyophilized
powder purified from human FFP
• Contain also small amounts of
fibrinogen & other proteins
• Can contain blood group Abs
• Treat patients with hemophilia A

26
Differences of Cryoprecipitate & Factor VIII concentrates
Cryoprecipitate
Factor VIII
concentrates
Storage Temp. -30oC
4oC
Short period RT
Risk of
Hepatitis
Low High
Treatment of
hemophilia A
Yes Yes
Treatment of
vW disease
Yes no

27
Factor IX Concentrate
• For the treatment Factor IX deficiency or
Hemophilia B (Christmas Disease).
• Have been used to treat patients with
acquired inhibitors of factor VIII
– Have factor VIII bypassing activity
• Contains also factors II, VII & X in
concentrated form
• Vials containing 500 units of factor IX

28
Factor IX Concentrate & liver
disease
• It is contraindicated in patients with liver
disease
– Have low levels of circulating antithrombin III
– Activation of clotting factors present in some
factor IX concentrates,
– cause DIC

29
Blood products & treatment of specific clotting factor deficiencies
Deficiency Blood product Indicated
Fibrinogen
Cryoprecipitate
Stored plasma
Factor V
Fresh frozen plasma
Frozen plasma
Factor VII
Factor IX concentrate
Stored plasma
Factor VIII
Factor VIII concentrate
Cryoprecipitate
Von Willebrand’s Disease
Cryoprecipitate
Fresh frozen plasma
Frozen plasma
Factor IX Factor IX concentrate
Factor X Stored plasma
Factor XI Stored plasma
Factor XIII Stored plasma

30
2- Oncotic Agents
• Albumin: volume expansion
• Other colloids are available for blood
volume expansion
– Dextran
– Gelatin
– Hydroxyethyl starch
– Polyvinylpyrrolidone

31
Albumin
• Albumin is prepared by ethanol
fractionation of pooled plasma
• Available in 5% and 25% concentrations.
• Have physiological sodium content
• No risk of hepatitis, sterilized during
preparation
• No coagulation factors or blood group Abs

32
Albumin
• Used for treatment of hypovolaemia and
hypoalbuminaemia (result from abnormal
synthesis, increased metabolism or loss)
• It maintains capillary osmotic pressure
• Carrier protein for drugs, hormones,
enzymes & metabolites

33
Plasma protein Fraction
• Partially purified albumin
• Contains ≈ 85% albumin & 15% other
plasma proteins

34
3- Immune Globulins
• Contains immune IgG antibodies,
prepared from pools of plasma.
• For disease prophylaxis, hepatitis A,
measles, varicella and rubella.
• For the treatment of hypogammaglobulin-
emia and agammaglobulinemia.

35
Immune Serum Globulin (ISG)
• Primarily IgG Ab
• Prevention of some viral diseases
• Hypogammaglobulinemia
• Congenital immune deficiency
• Given by IM injection (aggregates of IgG)

36
Hepatitis B Immune Globulin
(HBIG)
• Contains Hepatitis B immune antibodies.
• From plasma of donors with high titer of
Ab to HBsAg
• Provides passive immunization for HBV.
• For treatment after exposure to HBsAg.
• For the prevention of maternally
transferred HBV (perinatal exposure).

37
Varicella-Zoster immune globulin (VZIG)
• Derived from patients had recent Herpes
Zoster infections
• Herpes Zoster infections result in severe
fatal infection in immunocompromised
individuals
• Passive administration of VZIG during 72
hours of exposure can prevent or
attenuate infection

38
Rh Immune Globulin (RhIG)
• Derived from Rh -ve individuals
• Contains IgG antibodies to the D antigen on red
blood cells.
• Given during pregnancy and post-natally to Rh
negative mothers to prevent the development of
anti-D and hemolytic disease of the newborn
(HDN) due to anti-D.
• Given prophylacticaly following abortion, or
invasive maternal procedures (e.g.,
amniocentesis).

39
Tetanus Immune Globulin (TIG)
• Prepared from individuals specifically
immunized for tetanus toxoid
• Available for individuals at risk following
injury

Blood components Plasma.ppt

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Ähnlich wie Blood components Plasma.ppt

Ähnlich wie Blood components Plasma.ppt (20)

Mehr von drn00r

Mehr von drn00r (16)

Kürzlich hochgeladen

Kürzlich hochgeladen (20)

Blood components Plasma.ppt